The spine journal : official journal of the North American Spine Society
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Observational Study
Real-life results of balloon kyphoplasty for vertebral compression fractures from the SWISSspine registry.
The Swiss Federal Office of Public Health mandated a nationwide health technology assessment-registry for balloon kyphoplasty (BKP) for decision making on reimbursement of these interventions. The early results of the registry led to a permanent coverage of BKP by basic health insurance. The documentation was continued for further evidence generation. ⋯ The results of the largest observational study for BKP so far are consistent with published randomized trials and systematic reviews. In this routine health care setting, BKP is safe and effective in reducing pain, improving QoL, and lowering pain_killer consumption and has an acceptable rate of cement extrusions. Postoperative outcome results show clear and significant clinical improvement at early follow-up that remain stable during the first postoperative year.
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The diagnosis of sciatica is primarily based on history and physical examination. Most physical tests used in isolation show poor diagnostic accuracy. Little is known about the diagnostic accuracy of history items. ⋯ A few history items used in isolation had significant diagnostic value and the diagnostic accuracy of a model with six pre-selected items was poor.
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Traditionally, the "dynamic" and "static" types of spondylolisthesis have been lumped into a single group in the literature. The goal of this study was to define the radiographic characteristics of "dynamic" and "static" spondylolisthesis with the use of magnetic resonance imaging (MRI) and flexion/extension radiographs. ⋯ The presence of FF and/or ISF is associated with instability greater than 3 mm in flexion/extension radiographs.
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Perioperative visual loss (POVL) is a rare but devastating complication that may follow spinal surgeries. The incidence of POVL after spinal fusion is not well characterized during the past decade. ⋯ Our findings demonstrated an overall POVL incidence of 1.9 events per 10,000 spinal fusions. Patients undergoing thoracic fusion for deformity correction accounted for the majority of cases of POVL. Despite being a rare complication after spinal fusion, POVL is an adverse event that may not be entirely preventable. Patients undergoing long-segment fusions for deformity and those with certain risk factors should be counseled regarding the risks of POVL.
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Incidental durotomies occur in up to 17% of spinal operations. Controversy exists regarding the short- and long-term consequences of durotomies. ⋯ Within the context of an on-going debate on the consequences of incidental durotomy, we found no difference in neurologic symptoms, infection, reoperation, back pain, leg pain, or functional disability over a 2-year follow-up period.